Veterans on or nearing dialysis initiation must make critical decisions regarding dialysis modality and vascular access but feel unprepared to engage in decision-making. This study aims to explore Veterans' knowledge of dialysis and vascular access and their perspectives on communication during decision-making. Semi-structured interviews were conducted between October 2022 and July 2023 at a single center with U.S. Veterans referred for arteriovenous vascular access consultation. Inductive content analysis identified codes and emerging themes until thematic saturation was reached. Among 22 Veterans interviewed, the median age was 68.5 years, 95% ( n = 21) were male, 82% ( n = 18) self-identified as Black race, and 45% ( n = 10) were already on dialysis. There were three emerging themes: (1) Insufficient and delayed information on dialysis modality and vascular access; (2) Need for team-based care and communication; and (3) Concern about the negative impact of dialysis on quality of life. This study reveals that Veterans have limited awareness of dialysis modalities and vascular access options, as well as the potential impact of these choices on their quality of life. Veterans seek earlier and more effective communication from healthcare providers. Implementing interdisciplinary care teams may enhance communication and facilitate shared decision-making regarding dialysis and vascular access. • Veterans report limited knowledge of dialysis modality and vascular access options. • Information on dialysis modality and vascular access is insufficient and delayed. • Poor communication across care teams hinders shared decision-making. • Interdisciplinary, patient-centered care can improve outcomes and satisfaction.
Brathwaite et al. (Fri,) studied this question.